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Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island
Using information from the all-payer claims database for Rhode Island covering more than three-quarters of health insurance enrollees in the state from April 2011 through May 2019, this paper offers new measures of the association between the Medicaid expansion and the rate of receipt of buprenorphine and methadone for opioid use disorder (OUD). These robust measures adjust for the extent to which new Medicaid payments for these medications that started in 2014 crowded out payments from either non-Medicaid insurance or from non-insurance subsidies for the treatment of opioid abuse. We find ...
Working Paper
Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database
Previous research suggests that state Medicaid expansions implemented under the Patient Protection and Affordable Care Act (ACA) helped large numbers of patients suffering from opioid use disorder (OUD) gain access to life-saving medications, including buprenorphine. However, Medicaid expansions could have impeded access to care among individuals already enrolled in Medicaid, as new enrollees would have placed added demands on a limited supply of buprenorphine providers. Using a panel data set of medical claims from Rhode Island, we estimate the causal effects of the state’s January 2014 ...
Working Paper
Medicaid-ing Uninsurance? The Impact of the Affordable Care Act’s Medicaid Expansion on Uninsurance Spells
We study the effect of the Affordable Care Act’s Medicaid expansion on coverage dynamics following the sudden loss of coverage from an employer plan. This analysis leverages novel administrative data capturing monthly health insurance coverage for the U.S. population. Using these data, we develop several stylized facts describing the post-separation coverage dynamics. In addition, we use a difference-in-differences model to estimate the causal effect of Medicaid expansion on the duration of uninsurance following a separation from an employer plan. We find that Medicaid expansion increases ...